I'm a software engineer, and I spend a lot of time looking at computer and mobile phone screens. I also tend to stay late at work, which often means driving home in the dark.
You are a software engineer and spend a lot of time looking at computer and mobile phone screens and often drive home in the dark! Listen very carefully because this is critical to your decision.
Multifocal IOLs are not covered by insurance because they are considered "premium" devices. They cost a lot more. Why? Because the manufacturer charges more and because there is a huge markup by your surgeon. Are they worth it? Absolutely not. This is not a matter of "waiting for the insurance company to catch up with technology." And there is no litigious risk here on the part of insurance companies.
You have probably experienced using a digital camera. When you are pointing the camera at something in the distance and then bring the camera to bear on something near to you, the camera adjusts the focus. You can hear a little motor in the camera making the focusing change. If you have a $5,000 Nikon camera with an $8,000 lens attached to it, you will also hear a little motor adjusting the focus. WHY DOESN'T NIKON MAKE A LENS THAT CAN FOCUS FAR AWAY AND NEAR WITHOUT HAVING TO ADJUST THE FOCUS? Simple answer: Because it is optically impossible. The picture quality would suffer trying to spread the depth of focus between distance and near (i.e., "reading distance").
Are some people happy with multifocal lenses? Yes. Is everybody happy? No. I have yet to examine a patient who could read as well with a multifocal IOL as patients with monofocal IOLs and reading glasses. In fact, every multifocal lens patient I have examined could see BETTER using reading glasses AFTER surgery. I can tell you, patients who have shelled out $5,000 or $6,000 and find out that a $10 pair of readers off the rack at Walmart helps them read are VERY unhappy.
Forget all the stuff about neural adaptation. Blur is blur. Halos are halos (i.e. spherical aberrations).You may, over time, forget what "really clear" looks like. Multifocal IOLs simply do not and can not provide the crispness of vision of monofocal implants.
In fact, one of the contraindications for implanting multifocal IOLs is for patients with macular degeneration. Why? Because patients with macular degeneration already have compromised visual acuity and the MF IOLs will make their vision worse. This implies that patients WITHOUT macular degeneration have so much visual quality to spare that they can afford to lose a little! You are just 55 years of age. You may well live to be 85 or 95 and may well develop macular degeneration. At that point you would dearly welcome the difference in visual quality that monofocal IOLs provide.Your occupation is visually demanding.
Once the IOLs are in, it becomes risky to remove them and the window for IOL exchange is limited to a month or sixth weeks. By the way... You can still wear progressive addition lenses in your glasses. Your Rx does not have to be strictly reading glasses.
I am an optometrist, accustomed to hearing how people see every day, and there is a distinct difference in patients' responses with multifocal IOLs. There is a good chance your surgeon doesn't truly grasp this visual quality difference. A lot of surgeons don't refract patients. Cranking up a 150 watt bulb just above your book is no way to read and certainly no way to prove that multifocals allow sufficient clarity at near.
I know I am offering you a very strong opinion. It's necessary. One more reason why multifocals are expensive: Because everybody throngs to the prospect of never wearing glasses again. It's a big promise. But the fulfillment of that promise is the difference between your expectations and the reality of how light can be bent to a fine focus. Patient expectations all too frequently outrun the laws of physics.
Look in this same section of the bulletin board for what I wrote here: The case against multi-focal IOLs